Drug overbilling, Medicare, Medicaid, TRICARE, FEHB, Whistleblowing

The Department of Justice needs whistleblowers to report fraud involving drug pricing overbilling in the Medicare, Medicaid, TRICARE and FEHB programs.  There are potential rewards and protections for whistleblowers who have evidence of false claims against the Government.

In declining to dismiss a whistleblower’s lawsuit against Rite Aid for alleged drug overbilling, the court laid out the basis for its decision that the whistleblower’s lawsuit alleged sufficient evidence for the case to proceed.  The allegation was that Rite Aid charged Medicare, Medicaid, and TRICARE prices that exceeded prices paid by other customers.  A pharmacist who had worked for Rite Aid stepped forward with information that allowed the case to proceed, in April 2019.

Guidance is available for how to blow the whistle on your employer.  Reaching out to a former prosecutor who represents whistleblowers is a helpful first step.  An attorney can guide you through the process, assist you with documenting your concerns, answer your questions and instruct you on the nature and strength of evidence you do have.  A good whistleblower attorney will provide you a free consultation.  You should seek out an accomplished attorney as soon as you have concerns, and while you are still employed by the company where you believe there is wrong-doing.  Bottom line:  don’t do it alone.  Get an expert opinion from a prosecutor who’s tried False Claims Act cases and has significant experience under their belt.

The authors are former prosecutors who now represent whistleblowers / Renée Brooker (former Assistant Director for Civil Frauds) reneebrooker@finchmccranie.com (202) 288-1295 / Eva Gunasekera (former Senior Counsel for Health Care Fraud) eva@finchmccranie.com.

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Renée Brooker, former prosecutor representing whistleblowers